Provider Demographics
NPI:1497263016
Name:PICKETT, ARIANA (MSW, RCSWI)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:PICKETT
Suffix:
Gender:F
Credentials:MSW, RCSWI
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:
Other - Last Name:GARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 E NEW YORK AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-5527
Mailing Address - Country:US
Mailing Address - Phone:386-738-5543
Mailing Address - Fax:
Practice Address - Street 1:120 E NEW YORK AVE STE C
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-5527
Practice Address - Country:US
Practice Address - Phone:386-738-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL178501041C0700X
65435225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist